Jesper Fleischer

Vitamin B12 deficiency is associated with cardiovascular autonomic neuropathy in patients with type 2 diabetes

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  • Christian S Hansen, Department of Clinical Epidemiology, Steno Diabetes Center A/S, Gentofte, Denmark. Electronic address: csvh@steno.dk., Danmark
  • Jan S Jensen, Department of Cardiology, Gentofte Hospital, Copenhagen, Denmark
  • ,
  • Martin Ridderstråle, Steno Diabetes Center , Gentofte , Denmark.
  • ,
  • Dorte Vistisen, Department of Clinical Epidemiology, Steno Diabetes Center A/S, Gentofte, Denmark.
  • ,
  • Marit E Jørgensen, Department of Clinical Epidemiology, Steno Diabetes Center A/S, Gentofte, Denmark.
  • ,
  • Jesper Fleischer

AIMS: Vitamin B12 deficiency could be associated with cardiovascular autonomic neuropathy (CAN) in diabetes patients. We aim to investigate the association between serum levels of vitamin B12 and CAN in type 2 diabetes patients.

METHODS: 469 ambulatory type 2 diabetes patients (mean diabetes duration 10.0years (IQR 5.0;17.0), mean age 59.0years (SD 11.6), 63% men, mean B12 289.0pmol/l (IQR 217;390)) were screened for CAN using three cardiovascular reflex tests, five minute resting heart rate (5min RHR) and heart rate variability indices.

RESULTS: Serum levels of vitamin B12 were significantly lower in patients treated with metformin and/or proton pump inhibitors (PPIs) compared with patients not treated (p<0.001). A 25pmol/l higher level of vitamin B12 was associated with an odds ratio of the CAN diagnosis of 0.94 (95% CI 0.88; 1.00, p=0.034), an increase in E/I-ratio of 0.21% (95% CI 0.01; 0.43, p=0.038), and a decrease in 5min RHR of 0.25 beats per minute (95% CI -0.47; -0.03, p=0.025).

CONCLUSION: Vitamin B12 may be inversely associated with CAN in patients with type 2 diabetes. Confirmatory studies investigating a causal role of vitamin B12 for the development of diabetic CAN are warranted.

OriginalsprogEngelsk
TidsskriftJournal of Diabetes and its Complications
Vol/bind31
Nummer1
Sider (fra-til)202-208
Antal sider7
ISSN1056-8727
DOI
StatusUdgivet - jan. 2017

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